# Development of a urinary biomarker panel and software-based solutions to optimize treatment strategies for Systemic Juvenile Idiopathic Arthritis.

> **NIH NIH R43** · ETHOS RESEARCH AND DEVELOPMENT, LLC · 2020 · $224,592

## Abstract

Abstract
Systemic Juvenile Idiopathic Arthritis (SJIA) is a rare, auto-inflammatory condition characterized
by prolonged synovial inflammation that can lead to structural joint damage. Roughly 15-30% of
SJIA patients develop a complication called macrophage activation syndrome (MAS), which is
caused by excessive activation and proliferation of T cells along with macrophages. Patients
with recurrent MAS can develop interstitial lung disease (LD) with features of pulmonary
alveolar proteinosis caused by dysfunction of alveolar macrophages. Once lung disease is
diagnosed in children with SJIA, fatality occurs in 57% of patients within two years of
diagnosis. Identifying abnormal pathologies that occur early in disease progression and are
specific to subtypes of SJIA is imperative in order to improve the standard of care for patients
and prolong patient life. Ethos R&D proposes to develop a 2-part assay, consisting of
biomarkers related to inflammatory and non-inflammatory pathologies that are perturbed in
patients with SJIA, that can be analyzed from urine samples by high-performance liquid
chromatography, tandem mass spectrometry (LC-MS/MS). Along with the biomarker assay,
Ethos R&D will develop a software-based solution report according to biomarker analysis that
will communicate recommended adjuvant therapies for physicians, parents and patients.
Through collaboration with clinicians at CCHMC, we will be able to determine the specificity of a
urine-based test panel by analyzing subtypes of patients with SJIA (active SJIA, SJIA with MAS,
SJIA with lung disease) as compared to healthy controls (patient siblings). Such a technology
could provide life-changing standard of care for SJIA patients.

## Key facts

- **NIH application ID:** 9975573
- **Project number:** 1R43AR077338-01
- **Recipient organization:** ETHOS RESEARCH AND DEVELOPMENT, LLC
- **Principal Investigator:** Joshua Adam Gunn
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $224,592
- **Award type:** 1
- **Project period:** 2020-05-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9975573

## Citation

> US National Institutes of Health, RePORTER application 9975573, Development of a urinary biomarker panel and software-based solutions to optimize treatment strategies for Systemic Juvenile Idiopathic Arthritis. (1R43AR077338-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9975573. Licensed CC0.

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